Younger Women with DCIS Have a Higher Rate of Breast Cancer Recurrence

Women under age 44 with DCIS have a higher risk of recurrence. A large population-based study by of younger women with ductal carcinoma in situ (DCIS), a pre-invasive form of early-stage breast cancer, has found that women age 44 and younger have almost double the risk of recurrence following breast conservation surgery and radiation therapy than women age 45 to 50, whose rates were similar to known rates of women over 50.?We don?t yet know why younger women with DCIS have a higher rate of recurrence compared with older women,? said lead author Iwa Kong, MD, a breast oncology research fellow in the Department of Radiation Oncology at the Sunnybrook Health Sciences Centre and University of Toronto. ?Further research is necessary to determine the causes of this difference and to determine the best treatment for younger women with DCIS. It is important to add that these findings do not imply that all young women with DCIS need to undergo more aggressive surgery, such as a mastectomy, to reduce recurrence risk.?The researcher added that the roles of tamoxifen or higher doses of radiation also need to be evaluated. The incidence of DCIS has risen with the widespread use of mammography. While treatment with surgery and radiation has resulted in substantial reductions in recurrence, there has been concern that younger women may be at greater risk of recurrence.In this retrospective study, investigators examined the rate of breast cancer recurrence among women age 50 and younger diagnosed with DCIS in Ontario, Canada, between 1994 and 2003 who had standard breast conservation surgery (lumpectomy) and radiation therapy. After a median follow-up time of 8.5 years, the rate of recurrence among women age 44 and younger was significantly higher than those age 45 to 50 (20% for those age 40 and younger, 19 percent for those age 40 to 44, and 12% for those age 45 to 50). By comparison, the rate of recurrence among women over age 50 is typically 10 to 15% ten years after diagnosis.The results of this studies were presented duiring the 2009 (third) Breast Cancer Symposium held from October 8-10, 2009, at the San Francisco Marriott.Reference: Kong I, Rakovitch E, Taylor C, Nofech-Moses S, Hannah W, Paszat L. Outcomes of young women with DCIS treated with breast-conserving surgery and radiotherapy: A population-based analysis. Presented at the American Society of Clinical Oncology (ASCO) 2009 Breast Cancer Symposium. Abstract 127.